HIV: PrEP may boost use of other primary care resources

  • Marcus JL & al.
  • Am J Public Health
  • 19 Jul 2018

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Preexposure prophylaxis (PrEP) is independently associated with receipt of primary care (including influenza vaccination, tobacco/depression screenings, glucose testing).
  • PrEP use may broaden benefits to include behavioral and mental health, prevention/treatment of comorbid infectious and chronic diseases.

Why this matters

  • HIV-infected patients may have greater non-HIV-related care needs, providing PrEP users with additional benefits associated with more opportunities for non-HIV-related screenings.
  • Primary care practitioners should make an effort to offer PrEP to eligible patients with HIV.

Key results

  • 5857 HIV-uninfected individuals tested for rectal sexually transmitted infections.
  • 35% (2047/5857) were prescribed PrEP.
  • Overall, 40% (2357) participants had influenza vaccination, 74% (4352) tobacco screening, 72% (4211) depression screening, 51% (2984) glucose testing, 15% (894) HbA1c testing.
  • Compared with nonusers, higher proportion of PrEP users received influenza vaccination (adjusted prevalence ratio [aPR], 1.28; 98% CI, 1.20-1.37), tobacco screening (aPR, 1.06; 95% CI, 1.02-1.09), depression screening (aPR, 1.07; 95% CI, 1.04-1.11), and glucose testing (aPR, 1.78; 95% CI, 1.69-1.88).

Study design

  • Cross-sectional analysis comparing the proportion of PrEP users and nonusers receiving primary care.
  • Funding: National Institutes of Allergy and Infectious Diseases, National Institute of Mental Health.

Limitations

  • Cross-sectional design precludes conclusion causality, temporality.
  • Possibly nongeneralizable to community health centers with other missions.

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